The Minister for Health (Edward Argar)
Thank you, Mr Deputy Speaker.
My right hon. Friend the Secretary of State is currently at a Cobra meeting, determining the next stage of the Government response to the coronavirus. He therefore apologises for the fact that he is unable to open this debate. With your permission, Mr Deputy Speaker, he will be making a statement to the House a little later this afternoon. That will provide right hon. and hon. Members with the opportunity to question him on the latest position, so I urge colleagues to pause any specific questions related to coronavirus until that statement, when they will have the latest information.
May I also say that it is a pleasure to be back after last week’s precautionary self-isolation, following contact with a confirmed case and on Public Health England advice? It has subsequently advised me that, as I am symptom-free, I can return. Let me put on the record my thanks to PHE for the work it is doing for everyone at the moment, and to hon. Members and constituents for their kind words last week.
Coronavirus is the most serious public health challenge that our country has faced in a generation. Our goal is to protect life and to protect our NHS. Last week’s Budget showed that we will rise to that challenge. Under the plans laid out by my right hon. Friend the Chancellor, workers will have a strong safety net to fall back on if they fall sick, businesses will get financial help to stay in business, and the NHS will get whatever resources it needs. All in all, the Chancellor announced last week a total of £30 billion of investment in the financial health of the nation.
Kevin Brennan (Cardiff West) (Lab)
Many of those measures are extremely welcome, but is it not becoming clear that the economic impact of coronavirus is perhaps even greater than was anticipated, even last week? Perhaps now is the time to consider a temporary universal basic income for people who work as freelancers or who are self-employed, for the duration of the crisis.
Edward Argar
I am grateful to the hon. Gentleman for his comments. I believe that the package announced last week is the right package, at this time, to meet the challenges posed by this situation. Without necessarily referring to the hon. Gentleman’s particular proposal, I note that the Chancellor continues to keep all interventions under review as the situation develops. At the moment, what was proposed last week remains the right approach.
Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)
I underline my support for the comments of my hon. Friend the Member for Cardiff West (Kevin Brennan). The Minister asked us to wait to question the Secretary of State later, but I have a specific question about personal protective equipment. I am hearing a lot of concerns—shared throughout the country—about care homes, and particularly those involved in domiciliary care, as well as about some of the differentials between what is going on in private care homes and in public sector care homes. How is the Minister going to make sure that, working with the devolved Administrations, people throughout the whole UK get the PPE that they need, particularly in the care sector?
Edward Argar
I reassure the hon. Gentleman that, first, we are working across the four nations, because the situation needs an entire-United Kingdom response, and secondly, we are working extremely hard to ensure that all those who are on the frontline looking after people and keeping them safe get the protective equipment that they need. I suspect the Secretary of State will say a little more about that later this afternoon.
John Redwood (Wokingham) (Con)
Will the Government look again at the issue of the hospitality, travel and leisure industries? Some of those businesses are losing not just 10% or 20%, as they might in a normal recession, but the bulk of their revenue. Do they not need some revenue-sharing with the Government? Could we have a scheme like the German one to keep workers in work for a bit when they have a major loss of demand? I have declared my interests in the Register of Members’ Financial Interests—they are not in this particular sector.
Edward Argar
My right hon. Friend is right to highlight the challenges for particular sectors that are posed by what is currently happening, and he is right to mention the hotel and hospitality trade. Alongside the measures set out by the Chancellor last week, my right hon. Friend the Secretary of State for Digital, Culture, Media and Sport continues to have discussions, not only within his Department and across Government but with the sector, about what can be done to ensure that it gets the appropriate support that it needs as a sector.
Bob Seely (Isle of Wight) (Con)
Just to follow up on that point, I have several cases of businesses coming to me and saying that their business-interruption cover is not being recognised by their insurance companies because coronavirus was not a notifiable disease at the time. If the insurance industry takes that attitude nationwide, many businesses—not only in tourism and hospitality—are going to go to the wall, and my constituents on the Isle of Wight will be especially badly hit.
Edward Argar
My hon. Friend makes an important point. The Treasury, my hon. Friend the Economic Secretary to the Treasury and others are in conversations with the industry more broadly—I believe that more conversations are set to occur tomorrow—to ensure that businesses get the support that they need and are treated in a fair way.
Our investment in the financial health of the nation includes £40 million for literal vaccines, research and testing, because we base our decisions on the bedrock of the science. This national response is made possible because of our careful stewardship of the British economy over the past 10 years—because record numbers of businesses are making, selling and hiring; because millions more people are in work, earning and paying taxes; and because we have backed the NHS with a record long-term funding settlement.
This is a national effort and we will get through this together, as the Prime Minister has said. In Government, we will do the right thing at the right time, working through each stage of our coronavirus action plan guided by the science and the advice of our medical and scientific experts. We will stop at nothing to defeat the disease, but we will succeed only if everyone does their bit: washing their hands regularly; self-isolating for seven days if they have symptoms, such as a new, continuous, persistent cough or a high temperature; and looking out for their neighbours. In that spirit, may I thank the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), my constituency neighbour, and the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), for the constructive approach that they have taken since the start of the outbreak? They are doing their bit. They are good and decent people and public servants, and their approach is a prime example of how we can work together during this crisis.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
One question I am getting from constituents who already have medical conditions is to do with their worry over any interruption to their supply of medicine and their treatment. What reassurances can the Government give to people with epilepsy, for example, that they are still going to get the medication that they need?
Edward Argar
The NHS has robust procedures in place to ensure the continuity of medical supplies. In respect of supplies bought over the counter, I urge people not to stockpile, to behave responsibly and to buy what they need. In respect of prescription medicines, I can reassure the hon. Lady that we have very strong and robust processes in place to ensure that those medicines continue to be available.
Louise Haigh (Sheffield, Heeley) (Lab)
I wonder whether we could consider the language that we are using around the at-risk groups of people. Very few people will self-define as vulnerable or elderly, and, in fact, people with underlying health conditions might not even realise that they are particularly at risk of infection. Can we think about the language that we are using and specifically issue guidance to those groups of people?
Edward Argar
As ever, the hon. Lady makes a sensitive and sensible point. She is right that clarity in definitions and the language that is used is important. I do not want to pre-empt what my right hon. Friend may say in the House in a little while, but I think that she will see in the coming hours and days a greater degree of clarity for people and more information and guidance on that matter.
Jim McMahon
I thank the Minister for giving way. Clearly, we are very early into this, and we do not quite know what the business continuity impact will be or the financial impact on business. Do the Government have a framework by which they will operate and have discussions? For instance, when Virgin Atlantic comes forward and says that it needs financial support, what will be the framework of that support and what might the Government want in return for that investment?
Edward Argar
The hon. Gentleman makes a good point, which, almost to a degree, goes back to the point made by the hon. Member for Sheffield, Heeley (Louise Haigh) about giving people greater clarity and understanding of how things will work and in what way. Because the matters are fast evolving, as he says, they continue to be under review, but we will ensure that we work with industry—including both the example that he gives and others—to give the support that people need and that is most appropriate. Again, I hesitate to say this, but I caution slightly, as I did at the beginning, and say that if he waits until the Secretary of State’s statement, which I think is at half-past five, he may well get more details on that.
Coronavirus is the biggest challenge facing the NHS today. With clean hands and calm heads, we can help tackle it together, but, equally, we will not allow it to divert us from the long-term improvements that patients and staff rightly want to see. As the founders of the NHS knew better than anyone, we can fight the war while also planning for the peace.
Let me now turn to the measures in the Budget that will secure those long-term improvements. Last week, my right hon. Friend the Chancellor committed £6 billion of extra spending to support the NHS over the lifetime of this Parliament. That comes on top of our record long-term NHS funding settlement—£33.9 billion more over five years—which we have now enshrined in law. Most of the extra £6 billion will go towards delivering our flagship manifesto commitments. They include starting work on 40 new hospitals, 50,000 more nurses, and 50 million more appointments in primary care—more buildings, more people and more services. Let me take each in turn.
Peter Grant (Glenrothes) (SNP)
I thank the Minister for giving way. I can say quite honestly that it is an impressive list of capital spending commitments that he is giving us today. He will be aware that the Office for Budget Responsibility has based its longer term debt forecasts on the assumption that 20% of those capital promises will never actually happen. Does he accept that view from the Office for Budget Responsibility?
Edward Argar
The Office for Budget Responsibility is independent of the Government and sets out its opinions as it sees fit. We are committed to the hospital building programme. If the hon. Gentleman waits a moment, I will come to the detail of that capital spending.
The Budget increases my Department’s capital budget by £1 billion in 2020-21. That will allow trusts to continue investing in vital refurbishment and maintenance. Of course, we are funding the start of work on 40 new hospitals and the 20 hospital upgrades that are already under way. The work to plan and design those 40 new hospitals has already begun.
Mike Amesbury (Weaver Vale) (Lab)
Halton General Hospital campus—which, as the Minister knows, is part of Warrington and Halton Teaching Hospitals NHS Foundation Trust—has been turned down twice for capital funding for much needed refurbishment work. I plead once again for the Minister to ensure that it is prioritised; I am still waiting for a meeting with him.
Edward Argar
I hear what the hon. Gentleman says. As ever, he is a vocal champion for his constituents and his hospital. I say very gently that recent events have slightly impacted on my ability to schedule as many meetings as I might wish, but I remain committed to meeting him and talking to him about that particular project.
We want the new hospitals to be fully equipped with the very best modern technology, with touch screens, not clipboards, and systems that talk to each other. We also want them to be fully integrated with other local NHS organisations. But this is just the start, and we will follow this work up with multi-year capital funding through the spending review to be announced later this year.
Geraint Davies (Swansea West) (Lab/Co-op)
Is the Minister looking to divide up hospitals—new ones and, indeed, the existing ones—into coronavirus and non-coronavirus, with people wearing protective suits in coronavirus sections? China has been building a number of hospitals within weeks specifically to deal with this problem, so will the Minister refocus the programme he is outlining and bring it forward to address the coronavirus crisis?
Edward Argar
I suspect that Chinese building regulations and similar are possibly a little different from the processes in this country when it comes to speed, but the hon. Gentleman makes a good point. These hospitals, though, will be built for the future of our country—for the next 10, 20 and 30 years. He alludes to an important point and one that I was touching on in my speech, which is that we should ensure that our new buildings are adaptable and can be adapted to the changing needs of medical emergencies and the long-term demographic trends in this country. On that front, yes, we are building hospitals that are fit for the future, whatever that future may throw at us. But the issue he is raising is perhaps a little more short term than the length of time it will take us to build some of these hospitals.
Let me turn to people—the 1.4 million-strong team who make up the most dedicated workforce in the world. What is the one thing most NHS staff would change if they could change one thing? What is the best present we could give our nation’s nurses? [Interruption.] I will not be led astray by the Opposition. The answer is more nurses—more nurses to share the burden of rising demand, and more nurses bringing their compassion and determination to their work in the NHS. Over the next five years, we will deliver 50,000 more nurses for our NHS. We will do so by retaining and returning existing NHS staff, and by recruiting more nurses from abroad, but crucially by attracting more young people into the profession in the first place. The Budget delivers that by providing new non-repayable maintenance grants for nursing students of at least £5,000 a year for every undergraduate and postgraduate nursing student on a pre-registration course at an English university, with more for students with childcare costs or in disciplines such as mental health where the need is greatest. More than 35,000 students are expected to benefit.
In the coming months, the British people will have even more reason than usual to give thanks to our nation’s nurses, and we will work to repay them by making the NHS the country’s best employer—more supportive, more inclusive and more concerned with the wellbeing of staff as well as patients, an NHS that cares for its carers. We will set out how in our landmark NHS people plan.
We will also tackle the taper problem in doctors’ pensions, which has caused too many senior doctors to turn down work that the NHS needs them to do. Thanks to action in the Budget and the work of the Economic Secretary to the Treasury, from April the taxable pay threshold will rise from £110,000 to £200,000. That will take up to 96% of GPs and up to 98% of NHS consultants out of the scope of the taper based on their NHS income. I am particularly grateful to my hon. Friend for his work on delivering that.
Turning to staff in primary care, the Budget funds 6,000 more doctors and 6,000 more primary care professionals in general practice, on top of the 20,000 primary care professionals already announced. Why? It is because we want every NHS professional working at the very top of their skills register; because there are brilliant physios, pharmacists and healthcare assistants who can offer great treatment and advice for people seeking primary care; and because we can improve patient access to the NHS while freeing up GPs for those who need them most.
Ruth Cadbury (Brentford and Isleworth) (Lab)
While we welcome the numbers of professionals in the range of clinical areas that the Minister has outlined, can he tell me the numbers in each of those clinical specialisms and say when they will be ready to start work? When will they be fully trained and where will they come from?
Edward Argar
I set out in my remarks just now exactly where they would come from—from a variety of different sources. We have already seen, from the latest numbers for nurse recruitment, for example, many thousands more recruited in the last year. We are succeeding in delivering on our pledge, and we set out very clearly in our manifesto the timescales within which we would deliver.
That brings me to my third point—NHS services. I have said that I want the NHS to pursue two long-term policy goals to which my right hon. Friend the Secretary of State is committed. They are five extra years of healthy life and increased public confidence in the service. The coronavirus outbreak demonstrates that we have to target both. It is an explicit goal of our policy not just to tackle the disease, but to maintain public confidence. We take the same approach more broadly in healthcare. We want people to live healthier for longer, and we want people to be confident that the NHS will always be there for them, that it will treat them with dignity and respect, and that it will feel like a service, not an impersonal system. We want people to know, for instance, that they can always see a primary care professional whenever they need to. The Budget funds our manifesto commitment to create an extra 50 million appointments a year in general practice.
Alex Cunningham (Stockton North) (Lab)
I am grateful to the Minister for meeting me last week and very glad that I did not have to follow him into isolation. We had a good discussion last week and talked very much about those health inequalities and the necessity for more people to have more healthy years. I was grateful to him for being kind towards North Tees and Hartlepool and talking about a new hospital for Stockton. If there is a bit of capital to get that under way, I hope he will come up with it soon.
Edward Argar
The hon. Gentleman and, indeed, my hon. Friend the Member for Stockton South (Matt Vickers) are both strong advocates for Stockton and for the hospital there. I very much enjoyed our discussion. I am glad that the self-isolation rules are such that the hon. Gentleman did not have to follow me into it, but I am very happy, as I said when we met, to pick up on that discussion further in the future.
We also want people to know that the NHS will treat them fairly in their hour of need. That is why we care about hospital parking. Thanks to this Budget, from next month we will start the roll-out of free hospital parking more broadly across our hospital estate for disabled people, frequent out-patient attenders, parents with sick children staying overnight and staff working night shifts, delivering on our manifesto commitment.
Emma Hardy
I thank the Minister; it is a very quick one. Can that list of those eligible for free parking also include any students on a placement at the hospital—for example, nursing students or occupational therapists?
Edward Argar
The hon. Lady will know that the four categories I have just referred to are the four categories we explicitly referred to in the manifesto on which we were elected. As she knows, if she wants to write to me, I am always happy to receive and respond to letters from her on that issue.
The last measure I want to point to may have escaped notice last week, but it is an incredibly important part of putting the “service” into national health service. Too many people with autism or a learning disability are being treated as in-patients in mental health hospitals instead of being helped to live in their communities. In our manifesto, we committed to making it easier for them to be discharged from hospital. This Budget makes good on that commitment. It creates a new learning disability and autism community discharge grant that will be available to local authorities in England. That is new money and all local areas will receive a share of that funding.
Helen Hayes (Dulwich and West Norwood) (Lab)
I am grateful to the Minister for giving way. On that point concerning people with autism and learning disabilities in assessment and treatment units, can he advise on the arrangements that are being made during the coronavirus pandemic to ensure that those people currently in in-patient provision will not suffer additional isolation and further breaches of their human rights as a consequence of restrictions that might be put in place?
Edward Argar
The hon. Lady makes an important point, which is that throughout this challenge that we face as a country, we must ensure that everyone is treated with dignity and receives the care and support that they deserve. I was about to say that I know my right hon. Friend the Secretary of State will have heard what she said, but given he is in Cobra, he might not. I will ensure that he does. I will mention the matter to him, and in the context of the future tranches of guidance that will be coming forward in future days, the hon. Lady may want to raise the issue with him specifically later.
Modern buildings, more staff, an NHS that continues to truly serve its patients and a national response to coronavirus—that is what the Budget delivers. We can tackle this emergency while putting in place the long-term improvements that NHS clinicians are asking us for. We can fight the war against coronavirus as a united country, but we can also build the peace. We will stop at nothing to protect life and to protect and invest in our NHS. I commend the Budget to the House.
Mr Deputy Speaker (Mr Nigel Evans)
I point out that the statement on coronavirus will now be coming at 6 pm.
David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)
I am pleased to have the opportunity to speak in this debate. Harold Wilson said that a week was a long time in politics. During Brexit we found out that a week was even longer, but the Budget, only last Wednesday, seems a lifetime ago. Even when listening to the Chancellor, I still harboured hopes of a long-planned personal visit to New York this weekend, but for all the reasons we see around us that is simply not able to happen. Three weeks ago, I was in Rome for the Scotland-Italy rugby match. At that point, the talk was of difficulties in the north. No one envisaged that instead of the crowds in St Peter’s Square or outside the Colosseum there would be nobody.
As a Member of Parliament, I am often asked about the most difficult issue and time I have had to deal with. For me, the answer is very straightforward: the 2001 foot and mouth crisis, which affected my constituency deeply. I want to be very clear that I am not making any comparison between that disease and coronavirus. The comparison relates to the impact of an event of that scale on businesses and their continued prosperity, and on the wider community. There was also, as a report from Strathclyde University and others identified, the impact of isolation. During that period, very stringent measures were taken and many farmers had to be isolated on their own properties and could not leave. The report, two years later, made very clear the long-term consequences of isolation. We need to take those findings on board and think about them. We need to learn the lessons of such events, with measures that might come into place. I am sure those issues will be debated when we have more focused debates on coronavirus.
The businesses most affected by those circumstances were the self-employed and contractors, so we need to give those groups the maximum possible support. The hospitality industry was also very badly affected. One lesson from that experience is that small businesses need grants not loans. I remember taking part in a demonstration—I know that that will surprise you, Mr Deputy Speaker—outside the offices of Scottish Enterprise Dumfries and Galloway with colleagues in small businesses to make just that point. Grants, not loans, were needed to see them through. Rates relief is to be welcomed and I welcome the package of measures the Scottish Government have announced, but it is capped and we need to look again at whether that is appropriate.
The other big players are the banks. From my perspective, the situation that we face will be easier to deal with because it affects the whole United Kingdom, so the banks that are based outwith the south of Scotland and that are being asked to support businesses understand what is happening on the ground. We need that unity of purpose from the banks. Hon. Members who have dealt with the banks know that they always say the right thing, but doing it is something else, especially when the computer says no. We need to make sure that they follow through on their commitments, and on the positive tone that the Chancellor set in the Budget.
We need a uniformity of approach from the Government at all levels—the UK Government, the Scottish Government and local government. The underlying philosophy of all those institutions must be that we want to keep our businesses going and that we are not jobsworths who want the returns in on the exact date. That is why I welcome what the Chancellor said about VAT holidays and flexibility with Her Majesty’s Revenue and Customs. I am sure, however, that hon. Members on both sides of the House have experience of HMRC not being particularly flexible, so we need that to be followed through. That unity of purpose from government will be vital.
As has already been said in an intervention, the hospitality and tourism industry is the most vulnerable in a constituency such as mine. Often, as I found out during the foot and mouth crisis, businesses that have done well and are planning for the future are the worst hit. For example, the Gretna Green Famous Blacksmiths shop in my constituency, one of the most visited tourist attractions in Scotland, has won numerous awards for its attempts to attract Chinese visitors. A large number of Chinese visitors go to that location, but not any more—there are none. Its business model has already been seriously disrupted by these events. It is a bigger business, not a small business, but it needs help and support too, if that sector of the economy is to survive after these events.
Hotels in my constituency were already in difficulty; many, such as the Moffat House hotel, have closed. One local hotelier told me that they were facing a perfect storm of events, of which, at that stage, coronavirus was not one. I appeal directly to the Scottish Government on that issue, because the way that our business rates system in Scotland works for the hospitality industry, and particularly hotels, is still not right.
As I indicated, there are lots of lessons to learn. I hope that there is still the institutional knowledge in the Scottish Parliament and the Scottish Government to learn lessons from 2001, and that the Government can take some of those lessons on board, particularly in relation to isolation, as I said.
I welcome the Budget as a whole for Scotland, in particular the £640 million of additional funding for Scotland, which was £172 million more than the Scottish Government had anticipated. By any analysis, the Scottish Government got extra money. In my experience, they have not always welcomed, or even acknowledged, extra money—indeed, sometimes it was the wrong kind of money, even if they did acknowledge it. I hope that on this occasion, and in these circumstances, they will acknowledge the extra money.
As I said, I am pleased with what the Scottish Government have had to say about spending on business support in relation to coronavirus, but I would also like the money that is coming forward to be spent on infrastructure. Back in the ’90s, before the Scottish National party was in power, and when it held the constituency of Galloway and Upper Nithsdale, as it then was, the A75 and A76 were described as the most important forgotten roads in Scotland that needed to be substantially upgraded. Of course, since 2007 there has been an SNP, or SNP minority, Scottish Government, but that investment has not been forthcoming. I use this occasion to plead for the needs of the A75 and A76. I am sure that there is somebody in the SNP who remembers those previous commitments.
Obviously coronavirus is significantly affecting today’s debate, and rightly so, because it is the issue that most affects our constituents at the moment, but I want to highlight one other issue on which I wrote to the Chancellor ahead of the Budget, together with 15 Conservative colleagues, the Association of Convenience Stores and the British Retail Consortium: access to cash. It is a big issue; in a crisis, many people like to have some cash available, so that they have flexibility in how they approach difficult circumstances. There is a crisis in access to cash, and it affects large rural constituencies such as mine in particular, but also many other communities.
Some of the most deprived communities in our country bear the hardest impact. I had not realised until relatively recently that the average withdrawal from a cash machine is around £10 or £20. A fee of up to £3 to take £10 out of a cash machine is a very significant mark-up. A report has indicated that about 8 million people in our country are not ready to cope with a cashless society. A cashless society may come; indeed, when I travel from my constituency to central London, I feel that central London is, in many ways, a cashless society—in which there are, ironically, hundreds of cash machines. We need to do something about this issue. I welcome the Chancellor’s promise in his statement to legislate to secure the long-term future of cash, but it is very important that the steps that he takes are the right ones.
David Mundell
I am pleased to see the Minister nodding; I hope that he will nod when I say that those steps should include reversing the arbitrary cuts to the LINK interchange rates paid by banks to fund the network; exempting free-to-use ATMs from business rates; and recognising that ATMs are the only infrastructure through which we can guarantee national access to cash. Of course, cashback at convenience stores and other places has a role to play, but it is very important that we have a sustainably funded network of cash machines throughout the whole country, given the many branch closures we have seen in our constituencies—particularly Royal Bank of Scotland branch closures in Scotland.
I agree with the hon. Member for Ellesmere Port and Neston (Justin Madders). The consequences of these events—such as the foot and mouth crisis that afflicted much of the south of Scotland 20 years ago—go on for years. They do not just end when someone declares that the crisis is over. They go on for a long, long time for the businesses, individuals and communities that have been affected. We do not just pledge support to those individuals and communities today; we pledge it to see them all the way through the consequences. I think that that will mean revisiting some of what was announced in the Budget and some of what was announced by the Scottish Government, and if that is necessary, so be it.